After George Floyd died when a Minneapolis police officer knelt on his neck in late May, Martin Pierre, a psychologist, said his phone “was ringing off the hook.” New and existing clients — reeling from the familiar, though no less horrifying, shock of seeing another viral video of a Black man being brutalized by police — reached out in droves, many of them Black and seeking therapy for the first time.
“I get calls frequently, I get e-mails frequently, and I’m not able to serve the need,” said Pierre, a staff psychologist at Brandeis University and co-owner of Ashmont Counseling Services in Dorchester. “And it’s not only me, but it’s my colleagues [as well].”
The psychological toll inflicted by the coronavirus pandemic is finally becoming clear, as new evidence shows symptoms of depression and anxiety have surged since the outbreak disrupted American life this spring. But Black Americans, who have disproportionately suffered from COVID-19 and its economic fallout, are also shouldering an ever heavier mental health burden as a racial justice movement has ripped open centuries-old wounds of systemic oppression.
“I often call it the trifecta of trauma, or the health, wealth and stealth crisis,” said the Rev. Dr. Ray Hammond, pastor of Bethel AME Church, a mostly Black congregation in Jamaica Plain. Earlier this summer, Hammond invited Pierre, a member of his church, along with psychiatrist Dr. Kevin Simon of Boston Children’s Hospital and child psychologist Olivia Moorehead-Slaughter of The Park School in Brookline to speak with his congregants over Zoom about trauma and grief.
“The worst pandemic in 100 years, the worst unemployment in 80 years, and the worst social protests in 60 years all [colliding] in the second quarter of one year,” Hammond continued. “It’s hard, at least for me, not to imagine that’s not exacting a toll.”
Approximately 41 percent of Americans surveyed this June are coping with deteriorating mental health or substance use, according to a recent study by the Centers for Disease Control and Prevention. Roughly one in four Americans reported symptoms of anxiety, up from less than one in 12 over the same period last year. Nearly a quarter of Americans also showed symptoms of depression, a four-fold increase from the previous summer. Suicidal thoughts have spiked, too: About 11 percent of respondents said they had seriously considered suicide in the previous 30 days, more than twice as many as when adults were surveyed in 2018.
Black and Hispanic Americans — as well as young adults and essential workers — appear to be bearing the brunt of this seismic health crisis. More than 18 percent of Hispanic and 15 percent of Black respondents reported having suicidal thoughts, the researchers found, compared with 8 percent of white and 7 percent of Asian respondents. They also reported a higher prevalence of depression, symptoms of a trauma- and stress-related disorders, and substance use to cope with pandemic-induced distress.
“With the advent of the COVID-19 pandemic and the [spotlight on] systemic racism, these conditions have exacerbated the psychological issues that communities of color have faced historically,” said Pierre.
“For my older clients, there’s this fear of going outside, or this fear of inviting friends, relatives, or family members over to their home, and this is particularly concerning because when we look at the worldview of African-Americans, we are a collectivist people,” he added. Isolated and lonely, many feel disconnected, he said, and others have begun questioning their faith in God.
Meanwhile, the high-profile police and vigilante shootings of Black Americans, including Floyd, Breonna Taylor, Ahmaud Arbery and most recently, Jacob Blake of Kenosha, Wis., have compounded their trauma. Simon, a senior child and adolescent psychiatry fellow at Boston Children’s, said some of his young Black patients have expressed fears that their parents wouldn’t return home from work, worried that they’d be killed by police.
“For kids of color, repeatedly seeing visual images of traumatic events, like someone dying by armed forces, is obviously not settling. So they do end up having more anxiety and an even greater propensity for having a traumatic response,” Simon said. He pointed to a 2019 study that linked exposure to online images and videos of Black people being shot by police to poor mental health outcomes, including symptoms of PTSD, among adolescents of color.
“My black and Latino patients ... definitely seem to be displaying at least more concerns related to the virus and more concerns related to the racial tensions that are occurring statewide and nationally,” he added.
Parents of Black children often ask Simon, who is only the Black psychiatrist in his department, when they should teach their children about racism or how to interact with police. The parents of his Black teenage patients have come to him with a more urgent question: How do they keep their children inside, where they’ll be safe?
“Parents are extremely fearful their son or child may be the next hashtag,” Simon said.
In the face of this mounting crisis, access to mental health care remains a significant challenge for many Black Americans. According to a 2018 survey from the Substance Abuse and Mental Health Services Administration, of the 4.8 million Black Americans with mental illness, nearly 70 percent did not receive treatment. The high cost and stigma of psychotherapy are barriers, and so is the luxury of privacy, Pierre said, as many providers have been forced to resort to online therapy sessions during the pandemic. Some of Pierre’s clients, who share cramped living quarters with other family members, have attended their virtual appointments while sitting in their cars.
“For African-American clients, it’s very difficult to get a mental health provider that shares the same cultural and ethnic background,” Pierre added. Only 4 percent of psychologists in the country are Black, according to the American Psychological Association, and even fewer, like Pierre, who recently became the first Black president of the Massachusetts Psychological Association, are Black men. Yet Black clients often prefer to see Black therapists, with whom they can better relate, he said.
“When clients of color see me, it’s almost as though they have seen God because they’re not expecting to see a Black male therapist,” Pierre said with a chuckle. “There is this sense of immediate connection.”
Pierre said non-Black providers must be trained in providing “culturally competent” care; otherwise, he warned, the consequences may be dire. While the suicide rate among Black adults remains low compared with their white counterparts, Black youths are increasingly taking their own lives. Suicide attempts for Black adolescents rose 73 percent between 1991 and 2017, according to a report released last year by the Congressional Black Caucus. Suicide is now the second-leading cause of death among Black children, ages 10 to 19.
“Unless we get more mental health providers who are serving the needs of underserved and historically marginalized populations, there may be an increase in suicide,” Pierre said. “[These] populations are not getting the services they want or desire because the waiting lists are simply too long.”
Toy Burton, of Roxbury, intimately understands the heartache of losing a loved one to suicide. In 1986, her older sister Denita Shayne Morris, or DeeDee, killed herself at the age of 23. Her death devastated Burton, who turned to alcohol and drugs to numb the pain. One evening, a few years later, Burton tried taking her own life, too.
“I just wanted the pain to stop,” said Burton, now 54 and more than two decades sober. Three years ago, Burton, who is Black, founded DeeDee’s Cry, a mental health awareness and suicide prevention organization, after noticing a dearth of local resources designed specifically for communities of color.
“We’re showing people it’s OK to talk. It’s OK to share,” Burton said. “It’s OK to say, ‘I need help.’”
The Samaritans 24-seven crisis helpline can be reached by calling or texting 877-870-4673. People experiencing a crisis can call also the Disaster Distress Helpline: 1-800-985-5990, the National Suicide Prevention Lifeline: 1-800-273-8255.